Clark, Deandra L

Clark, Deandra L is an individual health care provider with primary practice located at 250 Anderson St , Portland ME 04101-2545. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Social Worker. Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) is her primary health care specialty. Clark, Deandra L can be contacted via phone (207) 775-5671.

Contact Information

Primary practice address
250 Anderson St Portland ME 04101-2545
Phone: (207) 775-5671
Fax: (207) 871-1243
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X LC3715 Maine
Behavioral Health & Social Service Providers / Mental Health 101YM0800X XL2975 Maine
Behavioral Health & Social Service Providers / Social Worker 104100000X LS6308 Maine

Profile Details

NPI number 1588713655
LBN Legal business name Clark, Deandra L
Credentials M.S., LCPC-C, LADC
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 9th, 2007
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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